More than half of alcoholics show diffusely distributed neurocognitive impairment at treatment entry. Brain dysfunction usually is not permanent following cessation of use. However, there are individual differences in extent and rate of recovery. This beterogeneity of deficit and of recovery rates suggests that the longitudinal assessment of neurocognitive impairment across multiple domains of functioning is needed to more adequately study the relationship of impairment to outcome following treatment. The goal of this proposal is to obtain funds to complete a computerized data base and planned analyses of the impact of neurocognitive impairment on treatment outcome using longitudinal data previously collected in four treatment outcome studies of alcohol use disordered individuals. Variables assessing predictor and outcome constructs were collected prospectively during the first week of treatment and on three additional occasions spanning 12 mon. The obtained sample was demographicaIly diverse. 217 individuals completed the battery at treatment entry. By imputing data for subjects missing no more than one of the three re-assessments, we will be able to analyze longitudinal data for 81 % of the subjects at 6 wks and 70% of the subjects at 6 and 12 mons. We propose to conduct descriptive analyses of short- and long-term patterns of stability and change in neurocognitive functioning both at the level of manifest variables and broader constructs representing four major domains of functioning: verbal abilities, memory, abstract reasoning/executive functioning, and perceptual/motor skills. Prototypical neurocognitive recovery groups based on initial level and intraindividual changes in neurocognitive functioning over time will be described. Relevant subject characteristics (e.g., age, sex, and familial alcoholism history) will be examined as predictors of differences in initial level and growth trajectories of neurocognitive performance. Differences in initial level and in subsequent changes in neurocognitive functioning will be tested as predictors of short-term (i.e., 6 wks) and longer term (i.e., 6 and 12 mon) treatment outcomes. In a subset of the data (N= 122), we will also test whether initial level and change in neurocognitive functioning moderate the effects of treatment process variables on treatment outcome, and whether their relation differs between those with an alcohol only, other drug only, or alcohol and other drug use disorder. Growth curve trajectories of changes in neurocognitive functioning, especially within the domains of executive controliabstraction and memory, are hypothesized to increase the prediction of treatment outcomes, over and above the effects of initial impairment. Further, initial level and subsequent changes in neurocognitive functioning are predicted to moderate the relation of change process factors (e.g. self-efficacy) to treatment outcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA011594-02
Application #
2769227
Study Section
Health Services Research Review Subcommittee (AA)
Project Start
1997-09-01
Project End
2000-04-30
Budget Start
1998-09-01
Budget End
2000-04-30
Support Year
2
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Rutgers University
Department
Psychology
Type
Other Domestic Higher Education
DUNS #
038633251
City
New Brunswick
State
NJ
Country
United States
Zip Code
08901
Buckman, Jennifer F; Bates, Marsha E; Morgenstern, Jon (2008) Social support and cognitive impairment in clients receiving treatment for alcohol- and drug-use disorders: a replication study. J Stud Alcohol Drugs 69:738-46
Buckman, Jennifer F; Bates, Marsha E; Cisler, Ron A (2007) Social networks and their influence on drinking behaviors: differences related to cognitive impairment in clients receiving alcoholism treatment. J Stud Alcohol Drugs 68:738-47
Lashin, Ossama M; Szweda, Pamela A; Szweda, Luke I et al. (2006) Decreased complex II respiration and HNE-modified SDH subunit in diabetic heart. Free Radic Biol Med 40:886-96
Bates, Marsha E; Voelbel, Gerald T; Buckman, Jennifer F et al. (2005) Short-term neuropsychological recovery in clients with substance use disorders. Alcohol Clin Exp Res 29:367-77
Cefaratti, Christie; Young, Andrew; Romani, Andrea (2005) Effect of ethanol administration on Mg2+ transport across liver plasma membrane. Alcohol 36:5-18
Bates, Marsha E; Barry, Danielle; Labouvie, Erich W et al. (2004) Risk factors and neuropsychological recovery in clients with alcohol use disorders who were exposed to different treatments. J Consult Clin Psychol 72:1073-80
Bates, Marsha E; Lemay Jr, Edward P (2004) The d2 Test of attention: construct validity and extensions in scoring techniques. J Int Neuropsychol Soc 10:392-400
Lashin, Ossama; Romani, Andrea (2004) Hyperglycemia does not alter state 3 respiration in cardiac mitochondria from type-I diabetic rats. Mol Cell Biochem 267:31-7
Fals-Stewart, William; Bates, Marsha E (2003) The neuropsychological test performance of drug-abusing patients: an examination of latent cognitive abilities and associated risk factors. Exp Clin Psychopharmacol 11:34-45
Lashin, Ossama; Romani, Andrea (2003) Mitochondria respiration and susceptibility to ischemia-reperfusion injury in diabetic hearts. Arch Biochem Biophys 420:298-304

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